|
02BG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BG0ZZ
|
| Hospital Charge Code |
10724
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BG0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BG0ZZ
|
| Hospital Charge Code |
982
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BH0ZZ
|
| Hospital Charge Code |
983
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BH0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BH0ZZ
|
| Hospital Charge Code |
10726
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BJ0ZZ
|
| Hospital Charge Code |
984
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BJ0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BJ0ZZ
|
| Hospital Charge Code |
10728
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK0ZZ
|
| Hospital Charge Code |
10730
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK0ZZ
|
| Hospital Charge Code |
985
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK3ZZ
|
| Hospital Charge Code |
986
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK3ZZ
|
| Hospital Charge Code |
10731
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK4ZZ
|
| Hospital Charge Code |
10732
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BK4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BK4ZZ
|
| Hospital Charge Code |
987
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL0ZZ
|
| Hospital Charge Code |
10733
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL0ZZ
|
| Hospital Charge Code |
988
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL3ZZ
|
| Hospital Charge Code |
10734
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL3ZZ
|
| Hospital Charge Code |
989
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL4ZZ
|
| Hospital Charge Code |
990
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BL4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BL4ZZ
|
| Hospital Charge Code |
10735
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BM0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BM0ZZ
|
| Hospital Charge Code |
991
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BM0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BM0ZZ
|
| Hospital Charge Code |
10736
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BN0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BN0ZZ
|
| Hospital Charge Code |
992
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BN0ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BN0ZZ
|
| Hospital Charge Code |
10738
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BN3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BN3ZZ
|
| Hospital Charge Code |
10739
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BN3ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BN3ZZ
|
| Hospital Charge Code |
993
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|
|
02BN4ZZ
|
Facility
|
IP
|
$11,208.00
|
|
|
Service Code
|
ICD 02BN4ZZ
|
| Hospital Charge Code |
10740
|
| Min. Negotiated Rate |
$11,208.00 |
| Max. Negotiated Rate |
$11,208.00 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,208.00
|
|